Contraceptive Pill Review

If you have been advised by the surgery to submit a contraceptive pill review please use this form.

If you are human, leave this field blank.

About You

Height *

In Metres

Weight *

In KG

Contraception Pill Review

Do you regularly check your breasts?

Yes

Please ask reception for our information regarding the importance of regular breast self-examination.

Do you suffer from severe headaches or migraines?

Yes - But the Doctor is unaware

Yes - But the Doctor is aware

Please make an appointment to see your doctor to discuss your headaches if you have not already done so.

Are you experiencing any irregular bleeding?

Yes

Please book an appointment to see the practice nurse

I confirm that the information provided is accurate to the best of my knowledge

Important -

Good Friday and Easter Monday Bank Holidays We are closed on the following dates for the Good Friday and Easter Monday bank holidays: Good Friday Bank Holiday, Friday 7th April �... Find out more

Important -

From 31st March 2023 free GP video consultations via Livi will no longer be available for patients in North West (NW) Surrey – Elmbridge, Runnymede, Spelthorne and Woking. The... Find out more

Important -

For the month 1st to 28th February 2023, there were 165 missed appointments at your GP surgery. This is a combination of GP and nurse appointments. We would kindly ask th... Find out more

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